There are several states on the forefront of ensuring medical care is available to the uninsured:

Minnesota is the central state in the community benefit debate. Minnesota Attorney General Mike Hatch threatened to file a suit against 110 Minnesota hospitals if they were non-compliant with a two-year contract he established with the Minnesota Hospital Association that set the level of required charity care at 5% of operating costs and established guidelines for collection practices. The collection practice guidelines force hospitals to give patients with net incomes less than $125,000 the “most favored” discount rate of each hospital’s payers. This means that the uninsured in Minnesota get the same financial treatment as the patients with each hospital’s best insurance contracts.

One out of five California citizens is uninsured (7 million) and another 3 million are underinsured. California hospitals provide $4 billion in uncompensated care annually. The guidelines established by the California Healthcare Association are uniquely vivid among guidelines established by other state hospital associations and the American Hospital Association5 :

  • “Fear of a hospital bill should never prevent any Californian from seeking emergency health care services.”
  • “Financial assistance provided by the hospital is not a substitute for personal responsibility.”
  • “Patients who are at or below 300% of the FPL are eligible to apply for financial assistance under each hospital charity care
  1. 5 California Hospital Billing and Collection Practices: Voluntary Principles and Guidelines for Assisting Low-Income Uninsured Patients, California Healthcare Association, February 6 2004